Understanding telehealth mediated cancer care in Northern BC First Nations communities: health professionals’ perspectives
Bibliographic record
Abstract
Objective The use of telehealth to provide health service delivery to rural and remote First Nations populations Canada-wide has greatly increased in recent years. Telehealth provides a mechanism for these disadvantaged and underserved communities to access timely healthcare services that would otherwise be expensive, delayed or unavailable due to geographic and resource limitations. There are numerous benefits, challenges and cultural issues that must be understood from a healthcare professional perspective when providing telehealth care to First Nations communities. Once educated with respect to these issues and experienced in providing care, healthcare professionals are well poised to provide feedback with respect to improving telehealth mediated health care delivery. This thesis examines these issues in the context of using telehealth for patient care, specifically cancer care. Methods This thesis is divided into two phases. Phase one is a literature review assessing the use of telehealth, specifically in rural and remote First Nations communities in Canada. Phase 2 is a study using a survey to assess healthcare professionals who provide telelehealth mediated patient care (in particular cancer care) to Northern BC First Nations communities. The participants were contacted through the use of an online survey tool to assess their perceptions of benefits, challenges, and cultural awareness when providing patient care. The survey population consisted of onsite health professionals and urban health professionals providing patient care to Northern BC First Nations communities via telehealth. Specific participant groups of interest were (1) onsite cancer care professionals, (2) onsite other (non-cancer) care professionals, (3) urban cancer care professionals, and (4) urban other (non-cancer) care professionals. Results The participant population of 45 was too limited a sample size for inferential statistics to be conducted. Therefore our survey data was interpreted by comparing the mean composite scores of the participants groups within each category. Our survey data implied that onsite cancer care providers found fewer benefits and more challenges with respect to telehealth than the other participant groups. We did not see any differences between the participant groups with respect to cultural awareness. Conclusion Based on the literature we reviewed telehealth can reduce costs and extend health care services in a timely manner while at the same time complement conventional care to build stronger health care community relationships. Despite these positive benefits found in literature, our survey found onsite cancer care professionals did perceive fewer benefits and more challenges regarding telehealth use. Specific issues raised by our survey participants that need to be addressed are the physical disconnect associated with telehealth and the perception that telehealth is a replacement for conventional care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.012 | 0.009 |
| Scholarly communication | 0.010 | 0.004 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".